[Crying upon eating: the crocodile-tears syndrome]
R Rodrigues Pereira1, W F M Arts
1Medisch Centrum Rijnmond-Zuid, locatie St. Clara Ziekenhuis, afd. Kindergeneeskunde, Olympiaweg 350, 3078 HT Rotterdam. pereirar@mcrz.nl
Insights
Crocodile tears syndrome, a rare condition causing crying during feeding, occurs when facial nerves incorrectly innervate lacrimal glands. Treatment options include surgery or botulinum-A toxin injections.
Area of Science:
- Neurology
- Ophthalmology
- Pediatrics
Background:
- Crocodile tears syndrome (CTS) involves aberrant reinnervation of lacrimal glands by facial nerve fibers.
- This condition can manifest congenitally or arise secondary to trauma or infection.
Observation:
- A male infant presented with crying immediately upon initiating nursing, a characteristic symptom of CTS.
- The crying reflex during feeding suggests abnormal neural connections affecting the lacrimal apparatus.
Findings:
- The infant's presentation is consistent with a diagnosis of crocodile tears syndrome.
- Partial aberrant innervation of the lacrimal glands by efferent fibers of the facial nerve (VII) is the presumed pathophysiology.
Implications:
- Early diagnosis and intervention are crucial for managing CTS in infants.
- Therapeutic options, including surgical correction and botulinum-A toxin, offer potential for symptom alleviation.
Abstract:
A male infant who, since birth, had begun to cry as soon as he began to nurse was found to have the crocodile tears syndrome. It is thought that in this condition the lacrimal glands are partially innervated by efferent fibres of the facial nerve (VII). The syndrome may be congenital, but may also be a consequence of an infection or trauma. Treatment is surgical or by the use of botulinum-A toxin.
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